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The tumor immune microenvironment (TME), formed by immune cells, cytokines, and immunomodulators, strongly shapes therapeutic response. Epigenetic alterations such as DNA methylation and histone modification, together with enhanced drug exportation, are implicated in resistance development. Emerging work highlights how suppressive TME adaptations promote immune surveillance escape, enabling individualized targeting of TME components for improved therapy.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/drug-resistance-and-tumor-immune-microenvironment-an-overview-of-current-understandings-review/340041/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/drug-resistance-and-tumor-immune-microenvironment-an-overview-of-current-understandings-review/340041.png","ImageObject",300,407,{"name":92,"@type":93},"Miles","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-27","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What role does the tumor immune microenvironment (TME) play in drug resistance?","Question",{"text":112,"@type":113},"The TME forms a network of immune cells, cytokines, and immunomodulators that collectively shapes tumor response to treatment. Changes within this suppressive environment can facilitate drug resistance by promoting immune surveillance escape.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How do epigenetic changes contribute to drug resistance?",{"text":117,"@type":113},"Epigenetic changes, including DNA methylation and histone modification, are reported to contribute to the development of drug resistance in cancers.",{"name":119,"@type":110,"acceptedAnswer":120},"What therapeutic strategies are proposed based on the TME?",{"text":121,"@type":113},"The review identifies potential targets within the TME for developing novel therapeutic strategies, aiming to improve individualized cancer therapy and overcome resistance.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},340041,1790116725,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":46,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":31},13056703019404,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","INTERNATIONAL JOURNAL OF ONCOLOGY 65: 96, 2024  \nDrug resistance and tumor immune microenvironment: An overview of current understandings (Review)  \nYAN LIU 1,2 , JUN LIANG3 , YANPING ZHANG3 and QIE GUO 1  \n1Department of Clinical Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China; 2Department of Pharmacology, School of Basic Medicine, Qingdao University, Qingdao, Shandong 266021, P.R. China; 3Department of Radiology, Qingdao Haici Hospital, Qingdao, Shandong 266000, P.R. China  \nReceived May 29, 2024; Accepted August 8, 2024  \nDOI: 10.3892/ijo.2024.5684  \nAbstract. The use of antitumor drugs represents a reliable strategy for cancer therapy. Unfortunately, drug resistance has become increasingly common and contributes to tumor metas‑ tasisand local recurrence. The tumor immune microenvironment (TME) consists of immune cells, cytokines and immunomodu‑ lators, and collectively they influence the response to treatment. Epigenetic changes including DNA methylation and histone modification, as well as increased drug exportation have been reported to contribute to the development of drug resistance in cancers. In the past few years, the majority of studies on tumors have only focused on the development and progression of a tumor from a mechanistic standpoint; few studies have examined whether the changes in the TME can also affect tumor growth and drug resistance. Recently, emerging evidence have raised more concerns regarding the role of TME in the development of drug resistance. In the present review, it was discussed how the suppressive TME adapts to drug resistance characterized by the cooperation of immune cells, cytokines, immunomodula‑ tors, stromal cells and extracellular matrix. Furthermore, it was reviewed how these immunological or metabolic changes alter immuno‑surveillance and thus facilitate tumor drug resistance. In addition, potential targets present in the TME for developing novel therapeutic strategies to improve individualized therapy for cancer treatment were revealed.  \nContents  \n1. Introduction  \n2. Impaired tumor antigen presentation process  \nCorrespondence to: Professor Qie Guo, Department of Clinical Pharmacy, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, Shandong 266003, P.R. China  \nE‑mail: [guoqie822a@qdu.edu.cn](guoqie822a@qdu.edu.cn)  \nKey words: tumor immune microenvironment, drug resistance, cancer‑associated fibroblasts, tumor‑associated macrophages, extracellular matrix  \n3. Immunosuppression in the tumor  \n4. TAMs and tumor drug resistance  \n5. CAFs and tumor drug resistance  \n6. Therapeutic potential of targeting the TME  \n7. Conclusion and future prospects  \n1. Introduction  \nIn recent years, developmentsin the medical space have resulted in the establishment of several tumor treatment methods . However, drug therapy remains to be a primary strategy in the treatment for various types of cancers (1) . Unfortunately, drug resistance has become a huge obstacle for cancer therapy, often leading to relapse and metastasis . Drug resistance refers to a state in which tumor cells become insensitive to antitumor drugs, a significant factor contributing to the failure of therapy and a pressing challenge in cancer treatment (2) . Tumor cells can develop resistance to chemotherapeutic drugs through either natural or acquired mechanisms. Natural drug resistance refers to the natural resistance of tumor cells to chemotherapeutic drugs, either because the drug within the cell does not reach the concentration required to inactivate the target or because the tumor cells fail to respond to the induction of apoptotic mechanisms (3) . Acquired drug resis‑ tance develops gradually during the course of drug therapy: Typically, drug resistance is acquired by tumor cells following long‑term treatment with small doses of cytotoxic drugs (4) . While continuous chemotherapy can inhibit tumor growth and extend patient survival, cancer cells adapt to ef","cbCaie40pqIRKS56","https://ap.wps.com/l/cbCaie40pqIRKS56","pdf",3824139,"English","# Introduction\n## Impaired tumor antigen presentation process\n## Immunosuppression in the tumor\n## TAMs and tumor drug resistance\n## CAFs and tumor drug resistance\n## Therapeutic potential of targeting the TME\n## Conclusion and future prospects","[{\"question\":\"What role does the tumor immune microenvironment (TME) play in drug resistance?\",\"answer\":\"The TME forms a network of immune cells, cytokines, and immunomodulators that collectively shapes tumor response to treatment. Changes within this suppressive environment can facilitate drug resistance by promoting immune surveillance escape.\"},{\"question\":\"How do epigenetic changes contribute to drug resistance?\",\"answer\":\"Epigenetic changes, including DNA methylation and histone modification, are reported to contribute to the development of drug resistance in cancers.\"},{\"question\":\"What therapeutic strategies are proposed based on the TME?\",\"answer\":\"The review identifies potential targets within the TME for developing novel therapeutic strategies, aiming to improve individualized cancer therapy and overcome resistance.\"}]","Drug resistance and tumor immune microenvironment: An overview of current understandings - Review | PDF",1790033879]